Comparison of Therapeutic Response and Complications of Oral Osveral and Injection Desfereal Chelating Agent in Patient with Thalassemia Major

Abstract
Iron  overload  is  frequently  leads  to  excessive  iron  deposition  observed  in  patients  with thalassemia because they receive frequent blood transfusion. Deferasirox, new oral iron chelators reduce iron load in transfusion-dependent patients. This study was performed to compare the efficacy and side effects of Desfereal  versus  Osveral  in  treatment  of  iron  overload  in  transfusion  patients  with  β-Thalassemia  and intermediate thalassemia in Bandarabbas. Method: This clinical trial study performed on one hundred and thirty  eight  (above  of  two  years)  with  β-Thalassemia  and  intermediate  Thalassemia  in  Bandar  Abbas. Patients were assigned randomly in two groups (69 cases in Osveral group and 69 cases in deferral group). Complete blood  count, serum levels of Alanine aminotransferase (ALT), aspartate aminotransferase (AST), ferritin and creatinine were measured in both groups. First group receive 20 mg/kg oral Osveral daily and second group receive 40 mg/kg subcutaneous Desfereal pe12 hours. Complete blood count, serum levels of ALT,  AST,  ferritin  and  creatinine  were  measured  in  both  groups.  The  cases  reevaluated  after  4  and  8 months. The date was analyzed by SPSS version 16 software using descriptive, Chi-square test and T-test. Significant level was set as P<0.005. Results: A total of 138 transfusion dependent patients received Osveral (n=69) or Desfereal (n=69). Decrease serum level of ferritin and hemoglobin there was significantly but this difference  no  significant  in  both  groups.  Abnormal  laboratory  studies  with  Osveral  were  associated  with mild leukopenia (4.3%) and thrombocytopenia (5.8%) and with Desfereal were associated thrombocytopenia (1.4%). Conclusion: In this study transfusion dependent patient with thalassemia we observed a significant decrease in serum ferritin and hemoglobin with oral Osveral and  Desfereal. Osveral is an oral iron chelator has  acceptable  tolerability  and  appears  to  have  similar  effects  to  Desfereal  in  decreasig serum  iron  in patients with iron overload. More randomized studies should be undertaken to determine the effects and side effects of iron chelators for treatment of iron overload.

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